Abbreviated mpMRI protocol for diffuse liver disease: a practical approach for evaluation and follow-up of NAFLD

Cunha, Guilherme Moura; Villela-Nogueira, Cristiane Alves; Bergman, Anke; Lopes, Flávia Paiva Proença Lobo

doi:10.1007/s00261-018-1504-5

Cited by 23 publications

(23 citation statements)

References 51 publications

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“…Anthropometric measurements were recorded at baseline and follow-up. Abdominal MRI was performed at baseline and at 2 months' follow-up treatment using an abbreviated protocol (25) for the specific purpose of this study. Patients were imaged in a 1.5-T MR scanner (GE 450 W; GE Medical Systems, Milwaukee, WI, USA) in the supine position without the use of intravenous contrast administration.…”

Section: Outcome Measurementsmentioning

confidence: 99%

Efficacy of a 2-Month Very Low-Calorie Ketogenic Diet (VLCKD) Compared to a Standard Low-Calorie Diet in Reducing Visceral and Liver Fat Accumulation in Patients With Obesity

Cunha

Guzmán²,

Mello

et al. 2020

Front. Endocrinol.

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Background: Currently the treatment of non-alcoholic fatty liver disease (NAFLD) is based on weight loss through lifestyle changes, such as exercise combined with calorie-restricted dieting. Objectives: To assess the effects of a commercially available weight loss program based on a very low-calorie ketogenic diet (VLCKD) on visceral adipose tissue (VAT) and liver fat content compared to a standard low-calorie (LC) diet. As a secondary aim, we evaluated the effect on liver stiffness measurements. Methods: Open, randomized controlled, prospective pilot study. Patients were randomized and treated either with an LC or a VLCKD and received orientation and encouragement to physical activity equally for both groups. VAT, liver fat fraction, and liver stiffness were measured at baseline and after 2 months of treatment using magnetic resonance imaging. Paired t-tests were used for comparison of continuous variables between visits and unpaired test between groups. Categorical variables were compared using the χ 2-test. Pearson correlation was used to assess the association between VAT, anthropometric measures, and hepatic fat fraction. A significance level of the results was established at p < 0.05. Results: Thirty-nine patients (20 with VLCKD and 19 with LC) were evaluated at baseline and 2 months of intervention. Relative weight loss at 2 months was −9.59 ± 2.87% in the VLCKD group and −1.87 ± 2.4% in the LC group (p < 0.001). Mean reductions in VAT were −32.0 cm 2 for VLCKD group and −12.58 cm 2 for LC group (p < 0.05). Reductions in liver fat fraction were significantly more pronounced in the VLCKD group than in the LC group (4.77 vs. 0.79%; p < 0.005). Cunha et al. VLCKD for Visceral Fat and NAFLD Conclusion: Patients undergoing a VLCKD achieved superior weight loss, with significant VAT and liver fat fraction reductions when compared to the standard LC diet. The weight loss and rapid mobilization of liver fat demonstrated with VLCKD could serve as an effective alternative for the treatment of NAFLD.

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Section: Outcome Measurementsmentioning

confidence: 99%

Efficacy of a 2-Month Very Low-Calorie Ketogenic Diet (VLCKD) Compared to a Standard Low-Calorie Diet in Reducing Visceral and Liver Fat Accumulation in Patients With Obesity

Cunha

Guzmán²,

Mello

et al. 2020

Front. Endocrinol.

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“…In a prospective study with 25 patients, Cunha et al (45) used an abbreviated MRI protocol to analyze quantitative imaging features and assessed its use during treatment of patients with obesity and nonalcoholic fatty liver disease. All patients were referred for MRI evaluation during the course of a physical activity program for overweight and obesity treatment and underwent quantitative analysis of liver fat and iron content, liver stiffness, and visceral adipose tissue.…”

Section: Assessment Of Liver Fat and Fibrosis-non-mentioning

confidence: 99%

“…The abbreviated MRI protocol took less than 10 minutes to complete. Cunha et al (45) concluded that it represents a feasible, less costly, and accessible option for screening and monitoring patients with obesity, nonalcoholic fatty liver disease, and metabolic syndrome. Although no data exist with regard to use of abbreviated MRI protocols for iron overload, a reasonable protocol would focus on only the assessment of iron overload, without use of all of the other conventional sequences within a full contrast-enhanced MRI protocol.…”

Section: Assessment Of Liver Fat and Fibrosis-non-mentioning

confidence: 99%

Abbreviated MRI Protocols for the Abdomen

et al. 2019

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Technical advances in MRI have improved image quality and have led to expanding clinical indications for its use. However, long examination and interpretation times, as well as higher costs, still represent barriers to use of MRI. Abbreviated MRI protocols have emerged as an alternative to standard MRI protocols. These abbreviated MRI protocols seek to reduce longer MRI protocols by eliminating unnecessary or redundant sequences that negatively affect cost, MRI table time, patient comfort, image quality, and image interpretation time. However, the diagnostic information is generally not compromised. Abbreviated MRI protocols have already been used successfully for hepatocellular carcinoma screening, for prostate cancer detection, and for screening for nonalcoholic fatty liver disease as well as monitoring patients with this disease. It has been reported that image acquisition time and costs can be considerably reduced with abbreviated MRI protocols, compared with standard MRI protocols, while maintaining a similar sensitivity and accuracy. Nevertheless, multiple applications still need to be explored in the abdomen and pelvis (eg, surveillance of metastases to the liver; follow-up of cystic pancreatic lesions, adrenal incidentalomas, and small renal masses; evaluation of ovarian cysts in postmenopausal women; staging of cervical and uterine corpus neoplasms; evaluation of müllerian duct anomalies). This article describes some successful applications of abbreviated MRI protocols, demonstrates how they can help in improving the MRI workflow, and explores potential future directions. ©

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“…The abbreviated MRI exam has been embraced in the radiology community as an important and valuable initiative. Current studies focusing on the role of MRI in screening and surveillance have developed specialized protocols that are often abbreviated with applications in the prostate and liver . Variable imaging protocols have been used and in general show a similar diagnostic performance compared with the full protocol for the detection of occult malignancies.…”

Section: Abbreviated Mri As a Valuable Initiativementioning

confidence: 99%

“…Current studies focusing on the role of MRI in screening and surveillance have developed specialized protocols that are often abbreviated with applications in the prostate and liver. [85][86][87][88][89][90][91][92] Variable imaging protocols have been used and in general show a similar diagnostic performance compared with the full protocol for the detection of occult malignancies. Other novel applications include using abbreviated MRI in the pediatric population to decrease the duration of necessary sedation, and as a rapid and accurate imaging tool in the musculoskeletal setting to detect fractures and increase patient throughput in an emergency setting.…”

Section: Abbreviated Mri As a Valuable Initiativementioning

confidence: 99%

Abbreviated MRI of the Breast: Does It Provide Value?

Leithner

Moy

Morris

et al. 2018

Magnetic Resonance Imaging

125

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Abbreviated mpMRI protocol for diffuse liver disease: a practical approach for evaluation and follow-up of NAFLD

Abstract: An abbreviated mpMRI protocol consisting of liver fat and iron quantification, MR elastography, and VAT measurements is a feasible, less-costly, and accessible option for screening and monitoring of patients with obesity, NAFLD, and metabolic syndrome.

Cited by 23 publications

References 51 publications

Efficacy of a 2-Month Very Low-Calorie Ketogenic Diet (VLCKD) Compared to a Standard Low-Calorie Diet in Reducing Visceral and Liver Fat Accumulation in Patients With Obesity

Efficacy of a 2-Month Very Low-Calorie Ketogenic Diet (VLCKD) Compared to a Standard Low-Calorie Diet in Reducing Visceral and Liver Fat Accumulation in Patients With Obesity

Abbreviated MRI Protocols for the Abdomen

Abbreviated MRI of the Breast: Does It Provide Value?

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